Provider Demographics
NPI:1821679093
Name:HIGHTOWER, HAILEY SCOTT
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:SCOTT
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 US HIGHWAY 19 S
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-4878
Mailing Address - Country:US
Mailing Address - Phone:229-759-7028
Mailing Address - Fax:229-759-7030
Practice Address - Street 1:1205 US HIGHWAY 19 S
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763-4878
Practice Address - Country:US
Practice Address - Phone:229-759-7028
Practice Address - Fax:229-759-7030
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGAA-NP001394363LP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics